Price Transparencybeta Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

VALOR HEALTH

Emmett, ID · CCN 131318 · Rates published

3,610 distinct procedures filed
22 distinct payers
104,839 rate rows
2026-06-12 last MRF observed
Data quality

103,380 of 104,839 rate rows are consumer-grade (98.6%)

1,459 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
template filing: same amount across many unrelated codes — excluded 999
percent-of-charges filed in the dollar field — excluded from medians 280
per-diem day rate — not a per-procedure price 112
exceeds 10× this hospital's gross charge — excluded from medians 48
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 19
placeholder amount (≤ $0.02) — excluded from medians 1
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbVHEMMETTID&type=CDMWithoutLabel&fileType=CSV
Found on page https://valorhealth.org/cms-hpt.txt
Discovered viaCMS hospital list
Last fetch not_modified · 2026-08-18
Content fingerprint faabdf3c25a3da02… · 47,860,908 bytes · first seen 2026-08-01

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
J3357
HCPCS 		Ustekinumab, For Subcutaneous Injection, 1 Mg 20 $28,850.20 $63,281.85 $55,023.57 nat. median
$12,959
outlier · 4.2×
J2350
HCPCS 		Injection, Ocrelizumab, 1 Mg 20 $20,439.00 $67,248.30 $38,981.60 nat. median
$331
outlier · 117.8×
J3245
HCPCS 		Injection, Tildrakizumab, 1 Mg 20 $17,775.82 $58,485.92 $33,902.33 nat. median
$256
outlier · 132.4×
J9228
HCPCS 		Injection, Ipilimumab, 1 Mg 20 $8,790.34 $115,687.20 $32,041.57 nat. median
$8,184
outlier · 3.9×
J9042
HCPCS 		Injection, Brentuximab Vedotin, 1 Mg 20 $12,080.62 $39,747.60 $23,040.35 nat. median
$885
outlier · 26.0×
J2327
HCPCS 		Injection, Risankizumab-rzaa, Intravenous, 1 Mg 20 $10,527.83 $34,638.60 $20,078.84 nat. median
$961
outlier · 20.9×
J9144
HCPCS 		Injection, Daratumumab, 10 Mg And Hyaluronidase-fihj 20 $10,468.44 $34,443.23 $19,965.59 nat. median
$202
outlier · 98.8×
J3380
HCPCS 		Injection, Vedolizumab, Intravenous, 1 Mg 20 $9,263.18 $30,477.66 $17,666.89 nat. median
$150
outlier · 118.0×
J9301
HCPCS 		Injection, Obinutuzumab, 10 Mg 20 $8,528.43 $28,060.20 $16,265.57 nat. median
$272
outlier · 59.8×
J2323
HCPCS 		Injection, Natalizumab, 1 Mg 20 $8,454.16 $27,815.85 $16,123.92 nat. median
$136
outlier · 118.6×
J3101
HCPCS 		Injection, Tenecteplase, 1 Mg 20 $8,211.51 $27,032.48 $15,665.31 nat. median
$3,475
outlier · 4.5×
J9022
HCPCS 		Injection, Atezolizumab, 10 Mg 20 $7,799.22 $36,658.50 $15,627.52 nat. median
$5,498
outlier · 2.8×
27447
HCPCS 		Replacement Of Knee Joint, Both Sides Of Knee 21 $1,004.76 $55,517.76 $14,606.31 nat. median
$12,699
1.2× median
J2427
HCPCS 		Injection, Paliperidone Palmitate Extended Release (invega Hafyera, Or Invega Tr… 20 $3,534.12 $69,769.73 $14,224.06 nat. median
$2,512
outlier · 5.7×
J9311
HCPCS 		Injection, Rituximab 10 Mg And Hyaluronidase 20 $6,508.64 $24,487.43 $13,041.55 nat. median
$1,789
outlier · 7.3×
J9306
HCPCS 		Injection, Pertuzumab, 1 Mg 20 $6,749.98 $22,208.76 $12,873.68 nat. median
$67
outlier · 193.1×
6857918_1
CDM 		Viaflow Matrix 2.0cc 20 $6,468.77 $13,905.22 $12,337.34 nat. median
$12,337
1.0× median
J2506
HCPCS 		Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 20 $6,351.66 $20,909.82 $12,117.22 nat. median
$1,555
outlier · 7.8×
27130
HCPCS 		Replacement Of Thigh Bone And Hip Joint With Prosthesis 21 $1,006.67 $41,133.60 $11,260.52 nat. median
$13,040
0.9× median
J0517
HCPCS 		Injection, Benralizumab, 1 Mg 20 $5,786.62 $19,039.13 $11,036.35 nat. median
$801
outlier · 13.8×
J9271
HCPCS 		Injection, Pembrolizumab, 1 Mg 20 $5,722.33 $18,827.58 $10,913.72 nat. median
$254
outlier · 43.0×
J2353
HCPCS 		Injection, Octreotide, Depot Form For Intramuscular Injection, 1 Mg 20 $4,571.13 $22,508.63 $9,159.30 nat. median
$5,513
1.7× median
J0402
HCPCS 		Injection, Aripiprazole (abilify Asimtufii), 1 Mg 20 $4,314.02 $18,925.29 $8,644.14 nat. median
$8
outlier · 1081.9×
J9354
HCPCS 		Injection, Ado-trastuzumab Emtansine, 1 Mg 20 $3,950.59 $20,797.11 $7,915.91 nat. median
$4,097
1.9× median
Q5111
HCPCS 		Injection, Pegfilgrastim-cbqv (udenyca), Biosimilar, 0.5 Mg 20 $4,134.15 $13,602.15 $7,884.71 nat. median
$1,862
outlier · 4.2×
8928775_1
CDM 		Cage Screw M 35mm Ar930102 20 $3,480.11 $7,480.83 $6,637.33 nat. median
$6,637
1.0× median
J9303
HCPCS 		Injection, Panitumumab, 10 Mg 20 $1,793.92 $23,609.40 $6,539.02 nat. median
$1,725
outlier · 3.8×
J1306
HCPCS 		Injection, Inclisiran, 1 Mg 20 $3,415.99 $11,239.28 $6,515.03 nat. median
$43
outlier · 151.1×
J9299
HCPCS 		Injection, Nivolumab, 1 Mg 20 $1,284.47 $25,371.00 $6,437.89 nat. median
$2,649
outlier · 2.4×
C1889
HCPCS 		Implantable/insertable Device, Not Otherwise Classified 20 $3,193.58 $6,864.90 $6,090.85 nat. median
$2,377
outlier · 2.6×
J9308
HCPCS 		Injection, Ramucirumab, 5 Mg 20 $1,456.97 $23,968.50 $6,039.26 nat. median
$1,393
outlier · 4.3×
9056995_1
CDM 		Dynanite Niti Staple W/instrs 15wx12l 20 $3,023.76 $6,499.85 $5,766.96 nat. median
$5,767
1.0× median
J9358
HCPCS 		Injection, Fam-trastuzumab Deruxtecan-nxki, 1 Mg 20 $2,906.03 $9,561.42 $5,542.44 nat. median
$94
outlier · 58.7×
J9205
HCPCS 		Injection, Irinotecan Liposome, 1 Mg 20 $2,877.55 $9,467.70 $5,488.11 nat. median
$193
outlier · 28.5×
9479273_1
CDM 		Infinion 16 50cm 16 Contact Trial Lead Kit Sc231650e 20 $2,872.17 $6,174.00 $5,477.85 nat. median
$5,478
1.0× median
8924185_1
CDM 		Rf Probe Intracept Fg0043 20 $2,872.17 $6,174.00 $5,477.85 nat. median
$5,478
1.0× median
J2799
HCPCS 		Injection, Risperidone (uzedy), 1 Mg 20 $1,300.35 $21,393.98 $5,268.75 nat. median
$555
outlier · 9.5×
8986244_1
CDM 		Sm Instrument Kit F42540000s 20 $2,664.74 $5,728.10 $5,082.23 nat. median
$5,082
1.0× median
J2997
HCPCS 		Injection, Alteplase Recombinant, 1 Mg 20 $417.73 $28,655.67 $5,041.91 nat. median
$488
outlier · 10.3×
8897841_1
CDM 		Biorez Soft Tissue Scafold 20 $2,632.82 $5,659.50 $5,021.36 nat. median
$5,021
1.0× median
47785
HCPCS 		Connection Of Bile Duct Within Liver To Small Bowel Using Roux-en-y Connection 20 $2,537.92 $11,554.51 $4,887.42 nat. median
$4,124
1.2× median
93229
HCPCS 		Electrocardiogram (ecg) Up To 30 Days Continuous With Transmission Of Patient Tr… 20 $2,561.25 $5,505.64 $4,884.85 nat. median
$607
outlier · 8.0×
9276935_1
CDM 		Operating Room Services - General Classification 20 $2,489.76 $5,351.98 $4,748.51 nat. median
$4,749
1.0× median
6898451_1
CDM 		Powerport Isp MRI Port 20 $2,482.15 $5,335.61 $4,733.99 nat. median
$4,734
1.0× median
8918482_1
CDM 		Spdbrg Implant Sys Ar2600sbs11 20 $2,450.92 $5,268.48 $4,674.43 nat. median
$4,674
1.0× median
J9034
HCPCS 		Injection, Bendamustine Hcl (bendeka), 1 Mg 20 $2,449.59 $8,059.62 $4,671.89 nat. median
$88
outlier · 53.1×
J2278
HCPCS 		Injection, Ziconotide, 1 Microgram 20 $1,155.85 $18,046.20 $4,643.90 nat. median
$16
outlier · 294.5×
J1943
HCPCS 		Injection, Aripiprazole Lauroxil, (aristada Initio), 1 Mg 20 $2,411.37 $7,933.89 $4,599.01 nat. median
$5
outlier · 944.4×
8986242_1
CDM 		Single Use Kit F43008000s 20 $2,280.18 $4,901.47 $4,348.81 nat. median
$4,349
1.0× median
J2798
HCPCS 		Injection, Risperidone, (perseris), 0.5 Mg 20 $2,152.84 $9,444.42 $4,313.71 nat. median
$16
outlier · 275.5×

Other procedures at this hospital

Browse this hospital's 3,610 published procedures. Use the slice to choose what to show, then sort or filter any column.

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Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
J3357 HCPCS Ustekinumab, For Subcutaneous Injection, 1 Mg 20 20 $63,281.85 $60,117.76 $28,850.20 $63,281.85 $55,023.57 2026-06-12
J2350 HCPCS Injection, Ocrelizumab, 1 Mg 20 20 $44,832.20 $42,590.59 $20,439.00 $67,248.30 $38,981.60 2026-06-12
J3245 HCPCS Injection, Tildrakizumab, 1 Mg 20 20 $38,990.61 $37,041.08 $17,775.82 $58,485.92 $33,902.33 2026-06-12
J9228 HCPCS Injection, Ipilimumab, 1 Mg 40 20 $48,203.05 $45,792.90 $8,790.34 $115,687.20 $32,041.57 2026-06-12
J9042 HCPCS Injection, Brentuximab Vedotin, 1 Mg 20 20 $26,498.40 $25,173.48 $12,080.62 $39,747.60 $23,040.35 2026-06-12
J2327 HCPCS Injection, Risankizumab-rzaa, Intravenous, 1 Mg 20 20 $23,092.40 $21,937.78 $10,527.83 $34,638.60 $20,078.84 2026-06-12
J9144 HCPCS Injection, Daratumumab, 10 Mg And Hyaluronidase-fihj 20 20 $22,962.15 $21,814.04 $10,468.44 $34,443.23 $19,965.59 2026-06-12
J3380 HCPCS Injection, Vedolizumab, Intravenous, 1 Mg 20 20 $20,318.44 $19,302.52 $9,263.18 $30,477.66 $17,666.89 2026-06-12
J9301 HCPCS Injection, Obinutuzumab, 10 Mg 20 20 $18,706.80 $17,771.46 $8,528.43 $28,060.20 $16,265.57 2026-06-12
J2323 HCPCS Injection, Natalizumab, 1 Mg 20 20 $18,543.90 $17,616.71 $8,454.16 $27,815.85 $16,123.92 2026-06-12
J3101 HCPCS Injection, Tenecteplase, 1 Mg 40 20 $18,016.65 $17,115.82 $8,211.51 $27,032.48 $15,665.31 2026-06-12
J9022 HCPCS Injection, Atezolizumab, 10 Mg 40 20 $20,773.15 $19,734.49 $7,799.22 $36,658.50 $15,627.52 2026-06-12
27447 HCPCS Replacement Of Knee Joint, Both Sides Of Knee 40 21 $30,107.24 $28,601.88 $1,004.76 $55,517.76 $14,606.31 2026-06-12
J2427 HCPCS Injection, Paliperidone Palmitate Extended Release (invega Hafyera, Or Invega Tr… 120 20 $19,380.67 $18,411.64 $3,534.12 $69,769.73 $14,224.06 2026-06-12
J9311 HCPCS Injection, Rituximab 10 Mg And Hyaluronidase 40 20 $15,300.70 $14,535.67 $6,508.64 $24,487.43 $13,041.55 2026-06-12
J9306 HCPCS Injection, Pertuzumab, 1 Mg 20 20 $14,805.84 $14,065.55 $6,749.98 $22,208.76 $12,873.68 2026-06-12
6857918_1 CDM Viaflow Matrix 2.0cc 20 20 $14,189.00 $13,479.55 $6,468.77 $13,905.22 $12,337.34 2026-06-12
J2506 HCPCS Injection, Pegfilgrastim, Excludes Biosimilar, 0.5 Mg 40 20 $13,936.01 $13,239.21 $6,351.66 $20,909.82 $12,117.22 2026-06-12
27130 HCPCS Replacement Of Thigh Bone And Hip Joint With Prosthesis 40 21 $22,768.38 $21,629.97 $1,006.67 $41,133.60 $11,260.52 2026-06-12
J0517 HCPCS Injection, Benralizumab, 1 Mg 20 20 $12,692.75 $12,058.11 $5,786.62 $19,039.13 $11,036.35 2026-06-12
J9271 HCPCS Injection, Pembrolizumab, 1 Mg 20 20 $12,551.72 $11,924.13 $5,722.33 $18,827.58 $10,913.72 2026-06-12
J2353 HCPCS Injection, Octreotide, Depot Form For Intramuscular Injection, 1 Mg 40 20 $12,516.17 $11,890.36 $4,571.13 $22,508.63 $9,159.30 2026-06-12
J0402 HCPCS Injection, Aripiprazole (abilify Asimtufii), 1 Mg 40 20 $11,039.76 $10,487.77 $4,314.02 $18,925.29 $8,644.14 2026-06-12
J9354 HCPCS Injection, Ado-trastuzumab Emtansine, 1 Mg 40 20 $11,265.11 $10,701.85 $3,950.59 $20,797.11 $7,915.91 2026-06-12
Q5111 HCPCS Injection, Pegfilgrastim-cbqv (udenyca), Biosimilar, 0.5 Mg 20 20 $9,068.10 $8,614.70 $4,134.15 $13,602.15 $7,884.71 2026-06-12
8928775_1 CDM Cage Screw M 35mm Ar930102 20 20 $7,633.50 $7,251.83 $3,480.11 $7,480.83 $6,637.33 2026-06-12
J9303 HCPCS Injection, Panitumumab, 10 Mg 40 20 $9,837.25 $9,345.39 $1,793.92 $23,609.40 $6,539.02 2026-06-12
J1306 HCPCS Injection, Inclisiran, 1 Mg 20 20 $7,492.85 $7,118.21 $3,415.99 $11,239.28 $6,515.03 2026-06-12
J9299 HCPCS Injection, Nivolumab, 1 Mg 80 20 $7,752.25 $7,364.64 $1,284.47 $25,371.00 $6,437.89 2026-06-12
C1889 HCPCS Implantable/insertable Device, Not Otherwise Classified 20 20 $7,005.00 $6,654.75 $3,193.58 $6,864.90 $6,090.85 2026-06-12
J9308 HCPCS Injection, Ramucirumab, 5 Mg 40 20 $9,587.40 $9,108.03 $1,456.97 $23,968.50 $6,039.26 2026-06-12
9056995_1 CDM Dynanite Niti Staple W/instrs 15wx12l 20 20 $6,632.50 $6,300.88 $3,023.76 $6,499.85 $5,766.96 2026-06-12
J9358 HCPCS Injection, Fam-trastuzumab Deruxtecan-nxki, 1 Mg 20 20 $6,374.28 $6,055.57 $2,906.03 $9,561.42 $5,542.44 2026-06-12
J9205 HCPCS Injection, Irinotecan Liposome, 1 Mg 20 20 $6,311.80 $5,996.21 $2,877.55 $9,467.70 $5,488.11 2026-06-12
8924185_1 CDM Rf Probe Intracept Fg0043 20 20 $6,300.00 $5,985.00 $2,872.17 $6,174.00 $5,477.85 2026-06-12
9479273_1 CDM Infinion 16 50cm 16 Contact Trial Lead Kit Sc231650e 20 20 $6,300.00 $5,985.00 $2,872.17 $6,174.00 $5,477.85 2026-06-12
J2799 HCPCS Injection, Risperidone (uzedy), 1 Mg 140 20 $7,131.33 $6,774.76 $1,300.35 $21,393.98 $5,268.75 2026-06-12
8986244_1 CDM Sm Instrument Kit F42540000s 20 20 $5,845.00 $5,552.75 $2,664.74 $5,728.10 $5,082.23 2026-06-12
J2997 HCPCS Injection, Alteplase Recombinant, 1 Mg 40 20 $10,010.02 $9,509.53 $417.73 $28,655.67 $5,041.91 2026-06-12
8897841_1 CDM Biorez Soft Tissue Scafold 20 20 $5,775.00 $5,486.25 $2,632.82 $5,659.50 $5,021.36 2026-06-12
47785 HCPCS Connection Of Bile Duct Within Liver To Small Bowel Using Roux-en-y Connection 20 20 $8,580.70 $8,151.67 $2,537.92 $11,554.51 $4,887.42 2026-06-12
93229 HCPCS Electrocardiogram (ecg) Up To 30 Days Continuous With Transmission Of Patient Tr… 20 20 $5,618.00 $5,337.10 $2,561.25 $5,505.64 $4,884.85 2026-06-12
9276935_1 CDM Operating Room Services - General Classification 20 20 $5,461.20 $5,188.14 $2,489.76 $5,351.98 $4,748.51 2026-06-12
6898451_1 CDM Powerport Isp MRI Port 20 20 $5,444.50 $5,172.28 $2,482.15 $5,335.61 $4,733.99 2026-06-12
8918482_1 CDM Spdbrg Implant Sys Ar2600sbs11 20 20 $5,376.00 $5,107.20 $2,450.92 $5,268.48 $4,674.43 2026-06-12
J9034 HCPCS Injection, Bendamustine Hcl (bendeka), 1 Mg 20 20 $5,373.08 $5,104.43 $2,449.59 $8,059.62 $4,671.89 2026-06-12
J2278 HCPCS Injection, Ziconotide, 1 Microgram 40 20 $7,283.06 $6,918.90 $1,155.85 $18,046.20 $4,643.90 2026-06-12
J1943 HCPCS Injection, Aripiprazole Lauroxil, (aristada Initio), 1 Mg 20 20 $5,289.26 $5,024.80 $2,411.37 $7,933.89 $4,599.01 2026-06-12
8986242_1 CDM Single Use Kit F43008000s 20 20 $5,001.50 $4,751.43 $2,280.18 $4,901.47 $4,348.81 2026-06-12
J2798 HCPCS Injection, Risperidone, (perseris), 0.5 Mg 40 20 $5,509.23 $5,233.77 $2,152.84 $9,444.42 $4,313.71 2026-06-12
6824497_1 CDM Solyx Sis System 20 20 $4,927.90 $4,681.51 $2,246.63 $4,829.34 $4,284.81 2026-06-12
J0401 HCPCS Injection, Aripiprazole (abilify Maintena), 1 Mg 60 20 $4,731.34 $4,494.77 $2,157.02 $9,462.68 $4,277.13 2026-06-12
9006946_1 CDM 28x13x11 Speedplate Quad Sk50 20 20 $4,893.00 $4,648.35 $2,230.72 $4,795.14 $4,254.47 2026-06-12
6895011_1 CDM Arthroflex 35 X 35 1.5mm 20 20 $4,872.00 $4,628.40 $2,221.14 $4,774.56 $4,236.20 2026-06-12
75635 HCPCS CT Scan Of Abdominal Aorta And Both Leg Arteries With Contrast 20 20 $4,659.80 $4,426.81 $2,124.40 $13,979.40 $4,051.69 2026-06-12
J3358 HCPCS Ustekinumab, For Intravenous Injection, 1 Mg 20 20 $4,601.22 $4,371.16 $2,097.70 $6,901.83 $4,000.76 2026-06-12
J9302 HCPCS Injection, Ofatumumab, 10 Mg 40 20 $7,203.90 $6,843.70 $597.14 $19,647.00 $3,968.04 2026-06-12
9509053_1 CDM Precision Charging System Kit Sc64123 20 20 $4,550.00 $4,322.50 $2,074.35 $4,459.00 $3,956.22 2026-06-12
Q5113 HCPCS Injection, Trastuzumab-pkrb, Biosimilar, (herzuma), 10 Mg 40 20 $5,787.84 $5,498.44 $1,388.78 $12,794.16 $3,948.70 2026-06-12
70553 HCPCS MRI Scan Of Brain Before And After Contrast 20 20 $4,537.90 $4,311.01 $2,068.83 $13,613.70 $3,945.70 2026-06-12
71552 HCPCS MRI Scan Of Chest Before And After Contrast 20 20 $4,537.90 $4,311.01 $2,068.83 $13,613.70 $3,945.70 2026-06-12
Q5108 HCPCS Injection, Pegfilgrastim-jmdb (fulphila), Biosimilar, 0.5 Mg 20 20 $4,534.05 $4,307.35 $2,067.07 $6,801.08 $3,942.35 2026-06-12
6908142_1 CDM Lapidus Plate 20 20 $4,528.50 $4,302.08 $2,064.54 $4,437.93 $3,937.53 2026-06-12
J1944 HCPCS Injection, Aripiprazole Lauroxil, (aristada), 1 Mg 80 20 $6,049.35 $5,746.89 $1,575.43 $12,506.19 $3,918.61 2026-06-12
74183 HCPCS MRI Scan Of Abdomen Before And After Contrast 20 20 $4,482.70 $4,258.57 $2,043.66 $13,448.10 $3,897.70 2026-06-12
73223 HCPCS MRI Scan Of Arm Joint Before And After Contrast 40 20 $4,474.30 $4,250.59 $2,039.83 $13,422.90 $3,890.40 2026-06-12
70543 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck Before And After Contrast 20 20 $4,472.10 $4,248.50 $2,038.83 $13,416.30 $3,888.49 2026-06-12
J9312 HCPCS Injection, Rituximab, 10 Mg 40 20 $6,118.50 $5,812.58 $929.81 $15,296.25 $3,854.14 2026-06-12
73723 HCPCS MRI Scan Of Leg Joint Before And After Contrast 40 20 $4,422.30 $4,201.19 $2,016.13 $13,266.90 $3,845.19 2026-06-12
Q5117 HCPCS Injection, Trastuzumab-anns, Biosimilar, (kanjinti), 10 Mg 40 20 $5,612.72 $5,332.09 $1,346.76 $12,407.06 $3,829.23 2026-06-12
72158 HCPCS MRI Scan Of Lower Spinal Canal Before And After Contrast 40 20 $4,402.20 $4,182.10 $1,945.10 $13,613.70 $3,823.03 2026-06-12
9028095_1 CDM Achilles 3.9mm Ar9928bckdx 20 20 $4,342.50 $4,125.38 $1,979.75 $4,255.65 $3,775.80 2026-06-12
J1602 HCPCS Injection, Golimumab, 1 Mg, For Intravenous Use 20 20 $4,342.24 $4,125.13 $1,979.63 $6,513.36 $3,775.58 2026-06-12
72157 HCPCS MRI Scan Of Middle Spinal Canal Before And After Contrast 40 20 $4,322.70 $4,106.57 $1,872.61 $13,613.70 $3,751.16 2026-06-12
8928776_1 CDM Implant System Ar9400sbk 20 20 $4,312.50 $4,096.88 $1,966.07 $4,226.25 $3,749.72 2026-06-12
J9173 HCPCS Injection, Durvalumab, 10 Mg 40 20 $5,669.96 $5,386.47 $1,000.62 $13,717.65 $3,730.74 2026-06-12
Q5112 HCPCS Injection, Trastuzumab-dttb, Biosimilar, (ontruzant), 10 Mg 40 20 $5,466.60 $5,193.27 $1,311.70 $12,084.06 $3,729.55 2026-06-12
J0897 HCPCS Injection, Denosumab, 1 Mg 40 20 $5,779.93 $5,490.94 $1,856.05 $11,233.04 $3,726.68 2026-06-12
6824533_1 CDM Stapler Reload Endo 60x3.5mm 20 20 $4,257.02 $4,044.17 $1,940.78 $4,171.88 $3,701.48 2026-06-12
Q4159 HCPCS Affinity, Per Square Centimeter 40 20 $4,319.32 $4,103.36 $1,784.23 $4,630.50 $3,575.12 2026-06-12
72156 HCPCS MRI Scan Of Upper Spinal Canal Before And After Contrast 40 20 $4,222.00 $4,010.91 $1,780.79 $13,613.70 $3,568.22 2026-06-12
J0129 HCPCS Injection, Abatacept, 10 Mg (code May Be Used For Medicare When Drug Administere… 20 20 $4,098.16 $3,893.25 $1,868.35 $6,147.24 $3,563.35 2026-06-12
6824854_1 CDM Novasure Device 20 20 $4,085.31 $3,881.04 $1,862.49 $4,003.60 $3,552.18 2026-06-12
Q4100 HCPCS Skin Substitute, Not Otherwise Specified 20 20 $4,062.50 $3,859.38 $1,852.09 $3,981.25 $3,532.35 2026-06-12
6871562_1 CDM Endostitch Device 20 20 $4,042.50 $3,840.38 $1,842.98 $3,961.65 $3,514.95 2026-06-12
59510 HCPCS Cesarean Delivery With Care Before And After Delivery 20 20 $7,346.90 $6,979.56 $2,081.52 $6,979.56 $3,506.48 2026-06-12
6824813_1 CDM Monarch Bladder Sling 20 20 $4,025.75 $3,824.46 $1,835.34 $3,945.24 $3,500.39 2026-06-12
70549 HCPCS MRI Scan Of Blood Vessels Of Neck Before And After Contrast 20 20 $4,002.60 $3,802.47 $1,824.79 $12,007.80 $3,480.26 2026-06-12
Q5115 HCPCS Injection, Rituximab-abbs, Biosimilar, (truxima), 10 Mg 40 20 $5,509.50 $5,234.03 $837.26 $13,773.75 $3,470.53 2026-06-12
74174 HCPCS CT Scan Of Blood Vessels Of Abdomen And Pelvis With Contrast 40 20 $3,977.10 $3,778.25 $1,813.16 $11,931.30 $3,458.09 2026-06-12
70546 HCPCS MRI Scan Of Blood Vessels Of Head Before And After Contrast 20 20 $3,955.90 $3,758.11 $1,803.49 $11,867.70 $3,439.65 2026-06-12
8928774_1 CDM Trunion 43mm Cap Ar930143cpc 20 20 $3,954.48 $3,756.76 $1,802.85 $3,875.39 $3,438.42 2026-06-12
6895401_1 CDM 4cc Pro-stim 20 20 $3,937.50 $3,740.63 $1,795.11 $3,858.75 $3,423.65 2026-06-12
6825286_1 CDM Allopure Small 20 20 $3,935.25 $3,738.49 $1,794.08 $3,856.55 $3,421.70 2026-06-12
Q5116 HCPCS Injection, Trastuzumab-qyyp, Biosimilar, (trazimera), 10 Mg 40 20 $4,997.97 $4,748.07 $1,199.25 $11,048.15 $3,409.82 2026-06-12
9483037_1 CDM Proximal Humeral Nail 8mm X 15cm 1170150 20 20 $3,892.50 $3,697.88 $1,774.59 $3,814.65 $3,384.53 2026-06-12
Q4101 HCPCS Apligraf, Per Square Centimeter 40 20 $4,079.36 $3,875.40 $1,685.11 $4,462.50 $3,376.51 2026-06-12
J0875 HCPCS Injection, Dalbavancin, 5 Mg 20 20 $3,864.28 $3,671.07 $1,761.73 $5,796.42 $3,359.99 2026-06-12
9509054_1 CDM Myscs Go Therapy Controller Kit M365sc55900 20 20 $3,850.00 $3,657.50 $1,755.22 $3,773.00 $3,347.57 2026-06-12
73220 HCPCS MRI Scan Of Arm Before And After Contrast 40 20 $3,849.90 $3,657.41 $1,755.17 $11,549.70 $3,347.49 2026-06-12
73720 HCPCS MRI Scan Of Leg Before And After Contrast 40 20 $3,849.90 $3,657.41 $1,755.17 $11,549.70 $3,347.49 2026-06-12
J9047 HCPCS Injection, Carfilzomib, 1 Mg 60 20 $3,841.40 $3,649.33 $583.76 $11,524.17 $3,340.10 2026-06-12
9525613_1 CDM Steerable Balloon Catheter Arc10sb 20 20 $3,822.00 $3,630.90 $1,742.45 $3,745.56 $3,323.23 2026-06-12
J9305 HCPCS Injection, Pemetrexed, Not Otherwise Specified, 10 Mg 40 20 $5,265.92 $5,002.62 $800.25 $13,164.80 $3,317.09 2026-06-12
J1569 HCPCS Injection, Immune Globulin, (gammagard Liquid), Non-lyophilized, (e.g., Liquid),… 60 20 $3,790.40 $3,600.88 $864.61 $11,371.20 $3,295.75 2026-06-12
8028141_1 CDM Room & Board - Other - Sterile Environment 11 11 $3,539.30 $3,362.34 $2,955.32 $3,468.51 $3,295.09 2026-06-12
J2315 HCPCS Injection, Naltrexone, Depot Form, 1 Mg 20 20 $3,671.42 $3,487.85 $1,673.80 $5,507.13 $3,192.30 2026-06-12
72197 HCPCS MRI Scan Of Pelvis Before And After Contrast 20 20 $3,631.60 $3,450.02 $1,655.65 $10,894.80 $3,157.68 2026-06-12
8878995_1 CDM Fem Nar Por Rt Sz6 150411226 20 20 $3,600.00 $3,420.00 $1,641.24 $3,528.00 $3,130.20 2026-06-12
9006018_1 CDM Femoral Por Ps Lt Sz5 150411105 20 20 $3,600.00 $3,420.00 $1,641.24 $3,528.00 $3,130.20 2026-06-12
9000544_1 CDM Biolox Fem Head 32mm 136532710 20 20 $3,574.32 $3,395.60 $1,629.53 $3,502.83 $3,107.88 2026-06-12
49418 HCPCS Insertion Of Abdominal Tube Using Imaging Guidance With Review By Radiologist 20 20 $3,524.50 $3,348.28 $1,606.82 $3,454.01 $3,064.56 2026-06-12
6825097_1 CDM Ascites Shunt 20 20 $3,487.75 $3,313.36 $1,590.07 $3,418.00 $3,032.60 2026-06-12
9000545_1 CDM Femoral Stem Sz 8 L971308 20 20 $3,450.00 $3,277.50 $1,572.86 $3,381.00 $2,999.78 2026-06-12
8928777_1 CDM Humeral Head 43/18 Ar934318 20 20 $3,450.00 $3,277.50 $1,572.86 $3,381.00 $2,999.78 2026-06-12
8018203_1 CDM Drill Bit 10.2 X 251mm Cann 20 20 $3,446.98 $3,274.63 $1,571.48 $3,378.04 $2,997.15 2026-06-12
J9264 HCPCS Injection, Paclitaxel Protein-bound Particles, 1 Mg 20 20 $3,431.91 $3,260.31 $1,564.61 $5,147.87 $2,984.05 2026-06-12
J7165 HCPCS Injection, Prothrombin Complex Concentrate, Human-lans, Per I.u. Of Factor Ix Ac… 20 20 $3,420.90 $3,249.86 $1,559.59 $5,131.35 $2,974.47 2026-06-12
6824531_1 CDM Stapler Reload Endo 45x3.5mm 20 20 $3,417.79 $3,246.90 $1,558.17 $3,349.43 $2,971.76 2026-06-12
8028225_1 CDM Room & Board - Other - Sterile Environment 11 11 $3,182.10 $3,182.10 $2,657.05 $3,118.46 $2,962.54 2026-06-12
8028202_1 CDM Room & Board - Other - Sterile Environment 11 11 $3,182.10 $3,182.10 $2,657.05 $3,118.46 $2,962.54 2026-06-12
J9355 HCPCS Injection, Trastuzumab, Excludes Biosimilar, 10 Mg 20 20 $3,386.69 $3,217.36 $1,543.99 $5,080.04 $2,944.73 2026-06-12
Q5123 HCPCS Injection, Rituximab-arrx, Biosimilar, (riabni), 10 Mg 40 20 $4,670.70 $4,437.17 $709.79 $11,676.75 $2,942.15 2026-06-12
Q5119 HCPCS Injection, Rituximab-pvvr, Biosimilar, (ruxience), 10 Mg 40 20 $4,670.70 $4,437.17 $709.79 $11,676.75 $2,942.15 2026-06-12
J9202 HCPCS Goserelin Acetate Implant, Per 3.6 Mg 40 20 $4,312.96 $4,097.32 $1,041.11 $9,513.42 $2,936.16 2026-06-12
74178 HCPCS CT Scan Of Abdomen And Pelvis Before And After Contrast 40 20 $3,347.50 $3,180.13 $1,526.13 $10,042.50 $2,910.65 2026-06-12
8992657_1 CDM Lag Drill Kit F43002000s 20 20 $3,325.00 $3,158.75 $1,515.87 $3,258.50 $2,891.09 2026-06-12
71275 HCPCS CT Scan Of Blood Vessels Of Chest With Contrast 20 20 $3,311.40 $3,145.83 $1,509.67 $9,934.20 $2,879.27 2026-06-12
J9035 HCPCS Injection, Bevacizumab, 10 Mg 40 20 $4,325.48 $4,109.20 $789.14 $10,380.00 $2,875.64 2026-06-12
27134 HCPCS Revision Of Thigh Bone And Hip Joint Prosthesis 20 20 $5,037.10 $4,785.25 $1,467.66 $4,847.90 $2,863.78 2026-06-12
8626080_1 CDM Pressfit Cup 47 Ds45320147 20 20 $3,242.73 $3,080.59 $1,478.36 $3,177.88 $2,819.55 2026-06-12
72130 HCPCS CT Scan Of Middle Spine Before And After Contrast 20 20 $3,239.40 $3,077.43 $1,476.84 $9,718.20 $2,816.66 2026-06-12
70496 HCPCS CT Scan Of Blood Vessels Of Head With Contrast 20 20 $3,236.20 $3,074.39 $1,475.38 $9,708.60 $2,813.88 2026-06-12
70471 HCPCS Computed Tomographic Angiography (cta), Head And Neck, With Contrast Material(s)… 20 20 $3,236.20 $3,074.39 $1,475.38 $9,708.60 $2,813.88 2026-06-12
J2802 HCPCS Injection, Romiplostim, 1 Microgram 40 20 $4,484.69 $4,260.45 $1,363.06 $8,969.33 $2,810.39 2026-06-12
72127 HCPCS CT Scan Of Upper Spine Before And After Contrast 20 20 $3,231.90 $3,070.31 $1,473.42 $9,695.70 $2,810.14 2026-06-12
8899895_1 CDM Spdbrg Implant Sys Ar2600sbs10 20 20 $3,225.00 $3,063.75 $1,470.28 $3,160.50 $2,804.14 2026-06-12
7575878_1 CDM Ligasure L-hook 37cm Lf5637 20 20 $3,201.94 $3,041.84 $1,459.76 $3,137.90 $2,784.09 2026-06-12
8028232_1 CDM Coronary Care Unit - General Classification 11 11 $2,977.50 $2,828.63 $2,486.21 $2,977.50 $2,772.05 2026-06-12
70498 HCPCS CT Scan Of Blood Vessels Of Neck With Contrast 20 20 $3,182.10 $3,023.00 $1,450.72 $9,546.30 $2,766.84 2026-06-12
71270 HCPCS CT Scan Of Chest Before And After Contrast 20 20 $3,168.30 $3,009.89 $1,444.43 $9,504.90 $2,754.84 2026-06-12
9477035_1 CDM Tcn Nitinol 10cm Electrode Tcn-10 20 20 $3,150.00 $2,992.50 $1,436.09 $3,087.00 $2,738.93 2026-06-12
9477036_1 CDM Tcn Nitinol 15cm Electrode Tcn-15 20 20 $3,150.00 $2,992.50 $1,436.09 $3,087.00 $2,738.93 2026-06-12
9009677_1 CDM Arthroflex 20x30x5mm Aflex652 20 20 $3,150.00 $2,992.50 $1,436.09 $3,087.00 $2,738.93 2026-06-12
9044711_1 CDM Endoblade Plantar Fascia Ar8856ds 20 20 $3,132.50 $2,975.88 $1,428.11 $3,069.85 $2,723.71 2026-06-12
J9145 HCPCS Injection, Daratumumab, 10 Mg 40 20 $4,036.65 $3,834.82 $768.05 $9,582.90 $2,719.81 2026-06-12
73706 HCPCS CT Scan Of Blood Vessels Of Lower Leg With Contrast 40 20 $3,094.10 $2,939.40 $1,410.60 $9,282.30 $2,690.32 2026-06-12
J2357 HCPCS Injection, Omalizumab, 5 Mg 20 20 $3,075.81 $2,922.02 $1,402.26 $4,613.72 $2,674.41 2026-06-12
J9217 HCPCS Leuprolide Acetate (for Depot Suspension), 7.5 Mg 80 20 $3,432.93 $3,261.28 $419.92 $8,829.62 $2,671.39 2026-06-12
9464265_1 CDM Amnioeffect 2x3cm Ls-5230 20 20 $3,066.00 $2,912.70 $1,397.79 $3,004.68 $2,665.89 2026-06-12
74175 HCPCS CT Scan Of Blood Vessels Of Abdomen With Contrast 40 20 $3,035.80 $2,884.01 $1,384.02 $9,107.40 $2,639.62 2026-06-12
Q5114 HCPCS Injection, Trastuzumab-dkst, Biosimilar, (ogivri), 10 Mg 40 20 $3,872.19 $3,678.59 $931.30 $8,552.42 $2,639.56 2026-06-12
23474 HCPCS Revision Of Total Shoulder Repair, Total Shoulder 20 20 $4,600.40 $4,370.38 $1,347.60 $4,426.89 $2,625.55 2026-06-12
C1734 HCPCS Orthopedic/device/drug Matrix For Opposing Bone-to-bone Or Soft Tissue-to Bone (… 40 20 $4,042.50 $3,840.38 $1,295.90 $5,137.65 $2,605.40 2026-06-12
J7325 HCPCS Hyaluronan Or Derivative, Synvisc Or Synvisc-one, For Intra-articular Injection,… 20 20 $2,973.18 $2,824.52 $1,355.47 $4,459.77 $2,585.18 2026-06-12
9223989_1 CDM 2.6 Fiber Tak Rc (blue) Ar3652tsp 20 20 $2,961.00 $2,812.95 $1,349.92 $2,901.78 $2,574.59 2026-06-12
6857913_1 CDM Hatched Titanium Probe Kit 20 20 $2,954.70 $2,806.97 $1,347.05 $2,895.61 $2,569.11 2026-06-12
72191 HCPCS CT Scan Of Blood Vessels Of Pelvis With Contrast 20 20 $2,923.50 $2,777.33 $1,332.82 $8,770.50 $2,541.98 2026-06-12
6824693_1 CDM Protak 5mm Lap Stapler 20 20 $2,923.20 $2,777.04 $1,332.69 $2,864.74 $2,541.72 2026-06-12
27132 HCPCS Total Hip Replacement After Previous Hip Surgery 20 20 $4,399.00 $4,179.05 $1,302.81 $4,264.90 $2,525.03 2026-06-12
73206 HCPCS CT Scan Of Blood Vessels Of Arm With Contrast 40 20 $2,897.00 $2,752.15 $1,320.74 $8,691.00 $2,518.94 2026-06-12
Q5107 HCPCS Injection, Bevacizumab-awwb, Biosimilar, (mvasi), 10 Mg 40 20 $3,788.62 $3,599.19 $690.91 $9,092.64 $2,518.39 2026-06-12
J3262 HCPCS Injection, Tocilizumab, 1 Mg 60 20 $2,884.20 $2,739.99 $525.96 $8,647.80 $2,507.82 2026-06-12
7411155_1 CDM 1.7mm Cann Drill Bit 100mm 20 20 $2,858.63 $2,715.70 $1,303.25 $2,801.46 $2,485.58 2026-06-12
J3111 HCPCS Injection, Romosozumab-aqqg, 1 Mg 20 20 $2,855.00 $2,712.25 $1,301.59 $4,282.50 $2,482.43 2026-06-12
9014610_1 CDM Dynanite Pip 12mm Ar4158ds12b 20 20 $2,842.50 $2,700.38 $1,295.90 $2,785.65 $2,471.55 2026-06-12
9244742_1 CDM Metatarsal Reamer, 22mm Ar8944mr22 20 20 $2,835.00 $2,693.25 $1,292.48 $2,778.30 $2,465.03 2026-06-12
9014616_1 CDM Metatar Reamer 20mm Ar8944mr20 20 20 $2,835.00 $2,693.25 $1,292.48 $2,778.30 $2,465.03 2026-06-12
9244743_1 CDM Phalangeal Reamer, 22mm Ar8944pr22 20 20 $2,835.00 $2,693.25 $1,292.48 $2,778.30 $2,465.03 2026-06-12
8972419_1 CDM Mtp Fusion Med 10 Rt 587221rt 20 20 $2,835.00 $2,693.25 $1,292.48 $2,778.30 $2,465.03 2026-06-12
9459995_1 CDM Endoblade Gastroc Recession System Ar8855ds 20 20 $2,835.00 $2,693.25 $1,292.48 $2,778.30 $2,465.03 2026-06-12
9014617_1 CDM Phalang Reamer 20mm Ar8944pr20 20 20 $2,835.00 $2,693.25 $1,292.48 $2,778.30 $2,465.03 2026-06-12
7019079_1 CDM Joystick For T10 Screw Holes 20 20 $2,830.46 $2,688.94 $1,290.41 $2,773.85 $2,461.09 2026-06-12
44603 HCPCS Suture Of Multiple Tears Or Holes In Small Bowel 20 20 $4,287.70 $4,073.32 $1,272.55 $5,805.01 $2,449.96 2026-06-12
8028201_1 CDM Room & Board - Private (one Bed) - General Classification 11 11 $2,620.30 $2,489.29 $2,187.95 $2,620.30 $2,439.50 2026-06-12
8028224_1 CDM Room & Board - Private (one Bed) - General Classification 11 11 $2,620.30 $2,489.29 $2,187.95 $2,620.30 $2,439.50 2026-06-12
8028197_1 CDM Room & Board - Private (one Bed) - Obstetrics (ob) 11 11 $2,620.30 $2,489.29 $2,187.95 $2,620.30 $2,439.50 2026-06-12
6978794_1 CDM 2.7mm Cann Drill Bit 160mm 20 20 $2,801.93 $2,661.83 $1,277.40 $2,745.89 $2,436.28 2026-06-12
23473 HCPCS Revision Of Total Shoulder Repair 20 20 $3,781.00 $3,591.95 $1,251.30 $4,102.07 $2,435.56 2026-06-12
9509051_1 CDM Fixate Suturing Device Fb20101 20 20 $2,800.00 $2,660.00 $1,276.52 $2,744.00 $2,434.60 2026-06-12
6971651_1 CDM Tfna Helical Blade 110mm 20 20 $2,795.63 $2,655.85 $1,274.53 $2,739.72 $2,430.80 2026-06-12
J2426 HCPCS Injection, Paliperidone Palmitate Extended Release (invega Sustenna), 1 Mg 100 20 $3,876.05 $3,682.25 $588.99 $11,628.30 $2,429.08 2026-06-12
C1762 HCPCS Connective Tissue, Human (includes Fascia Lata) 60 20 $3,600.00 $3,420.00 $542.52 $5,137.65 $2,427.02 2026-06-12
C9359 HCPCS Porous Purified Collagen Matrix Bone Void Filler (integra Mozaik Osteoconductive… 60 20 $4,690.50 $4,455.98 $889.01 $5,134.47 $2,425.51 2026-06-12
7119795_1 CDM 5.0mm Cann Drill Bit Qc/300mm 20 20 $2,764.13 $2,625.92 $1,260.17 $2,708.85 $2,403.41 2026-06-12
6824853_1 CDM Ligasure Laparoscopic Device 20 20 $2,760.77 $2,622.73 $1,258.64 $2,705.55 $2,400.49 2026-06-12
72194 HCPCS CT Scan Of Pelvis Before And After Contrast 20 20 $2,741.20 $2,604.14 $1,249.71 $8,223.60 $2,383.47 2026-06-12
72133 HCPCS CT Scan Of Lower Spine Before And After Contrast 20 20 $2,733.70 $2,597.02 $1,246.29 $8,201.10 $2,376.95 2026-06-12
8928773_1 CDM Vaultlock Glenoid Sm Ar910601 20 20 $2,716.50 $2,580.68 $1,238.45 $2,662.17 $2,362.00 2026-06-12
8028231_1 CDM Room & Board - Other - Sterile Environment 11 11 $2,527.00 $2,400.65 $2,110.05 $2,527.00 $2,352.64 2026-06-12
7321016_1 CDM 2.7mm Drill Bit Qc 160mm Grey 20 20 $2,702.70 $2,567.57 $1,232.16 $2,648.65 $2,349.99 2026-06-12
8924186_1 CDM Intracept Access Instruments 20 20 $2,700.00 $2,565.00 $1,230.93 $2,646.00 $2,347.65 2026-06-12
6824960_1 CDM Capio Ligature Device 20 20 $2,683.42 $2,549.25 $1,223.37 $2,629.75 $2,333.23 2026-06-12
6825209_1 CDM Tx1 Tissue Rem Sys-tenex 20 20 $2,677.50 $2,543.63 $1,220.67 $2,623.95 $2,328.09 2026-06-12
9495108_1 CDM Quadpro Harvester, 9mm Ar238609 20 20 $2,677.50 $2,543.63 $1,220.67 $2,623.95 $2,328.09 2026-06-12
70470 HCPCS CT Scan Of Head Or Brain Before And After Contrast 20 20 $2,660.60 $2,527.57 $1,212.97 $7,981.80 $2,313.39 2026-06-12
6825228_1 CDM Titanium Single Lumen Port 8fr 20 20 $2,652.72 $2,520.08 $1,209.38 $2,599.67 $2,306.54 2026-06-12
27138 HCPCS Revision Of Thigh Bone Prosthesis 20 20 $4,019.50 $3,818.53 $1,184.00 $3,885.24 $2,299.32 2026-06-12
6824986_1 CDM Elect Vapr Prem90 227204 20 20 $2,639.70 $2,507.72 $1,203.44 $2,586.91 $2,295.22 2026-06-12
7104185_1 CDM Disp Harvesting System 3.5mm 20 20 $2,620.80 $2,489.76 $1,194.82 $2,568.38 $2,278.78 2026-06-12
99468 HCPCS Initial Inpatient Hospital Critical Care Of Newborn Per Day (28 Days Or Younger) 11 11 $2,423.20 $2,423.20 $2,023.37 $2,374.74 $2,256.00 2026-06-12
8047192_1 CDM Blade Helical 120mm Tfn 20 20 $2,585.63 $2,456.35 $1,178.79 $2,533.92 $2,248.20 2026-06-12
7008665_1 CDM Tfna Fenestrated Helical Blade 90mm 20 20 $2,585.63 $2,456.35 $1,178.79 $2,533.92 $2,248.20 2026-06-12
7185226_1 CDM Tfna Helical Blade 80mm 20 20 $2,585.63 $2,456.35 $1,178.79 $2,533.92 $2,248.20 2026-06-12
7033330_1 CDM Tfna Helical Blade 85mm 20 20 $2,585.63 $2,456.35 $1,178.79 $2,533.92 $2,248.20 2026-06-12
6886592_1 CDM Tfna Helical Blade 90mm 20 20 $2,585.63 $2,456.35 $1,178.79 $2,533.92 $2,248.20 2026-06-12
8047193_1 CDM Blade-helical 125mm,tfn 20 20 $2,585.63 $2,456.35 $1,178.79 $2,533.92 $2,248.20 2026-06-12
7358190_1 CDM Tfna Fen Helical Blade 150mm 20 20 $2,585.63 $2,456.35 $1,178.79 $2,533.92 $2,248.20 2026-06-12
6873896_1 CDM Tfna Helical Blade 150mm 20 20 $2,585.63 $2,456.35 $1,178.79 $2,533.92 $2,248.20 2026-06-12
6825258_1 CDM Cellutome Harvester 5.0x5.0 20 20 $2,583.00 $2,453.85 $1,177.59 $2,531.34 $2,245.92 2026-06-12
72142 HCPCS MRI Scan Of Upper Spinal Canal With Contrast 40 20 $2,622.40 $2,491.28 $1,115.82 $8,391.90 $2,235.79 2026-06-12
72149 HCPCS MRI Scan Of Lower Spinal Canal With Contrast 40 20 $2,774.00 $2,635.31 $1,115.82 $9,301.50 $2,235.79 2026-06-12
72147 HCPCS MRI Scan Of Middle Spinal Canal With Contrast 40 20 $2,575.25 $2,446.49 $1,115.82 $8,109.00 $2,234.78 2026-06-12
27137 HCPCS Revision Of Hip Socket Part Of Hip Prosthesis 20 20 $3,870.10 $3,676.60 $1,141.01 $3,740.97 $2,214.15 2026-06-12
Q5118 HCPCS Injection, Bevacizumab-bvzr, Biosimilar, (zirabev), 10 Mg 40 20 $3,330.80 $3,164.26 $607.40 $7,993.92 $2,214.05 2026-06-12
72129 HCPCS CT Scan Of Middle Spine With Contrast 20 20 $2,539.80 $2,412.81 $1,157.89 $7,619.40 $2,208.36 2026-06-12
7202141_1 CDM 3.2mm Cannulated Drill Bit 20 20 $2,532.60 $2,405.97 $1,154.61 $2,481.95 $2,202.09 2026-06-12
74177 HCPCS CT Scan Of Abdomen And Pelvis With Contrast 40 20 $2,532.30 $2,405.69 $1,154.48 $7,596.90 $2,201.84 2026-06-12
6824578_1 CDM Power Port 1708000 Bard 20 20 $2,527.00 $2,400.65 $1,152.06 $2,476.46 $2,197.23 2026-06-12
72148 HCPCS MRI Scan Of Lower Spinal Canal Without Contrast 40 20 $2,699.25 $2,564.29 $1,094.07 $8,996.10 $2,192.22 2026-06-12
23472 HCPCS Prosthetic Repair Of Shoulder Joint, Total Shoulder 20 20 $3,824.50 $3,633.28 $1,129.40 $3,690.34 $2,190.59 2026-06-12
9009669_1 CDM Glenosphere 33+4 Ar95642433lat 20 20 $2,503.38 $2,378.21 $1,141.29 $2,453.31 $2,176.69 2026-06-12
6824108_1 CDM Port A Cath 9.6fr 0602660 20 20 $2,492.75 $2,368.11 $1,136.44 $2,442.90 $2,167.45 2026-06-12
8848734_1 CDM Mica Burr 2x12mm 57sr0212 20 20 $2,463.30 $2,340.14 $1,123.02 $2,414.03 $2,141.84 2026-06-12
27486 HCPCS Revision Of Component Of Total Knee Joint Prosthesis 20 20 $3,674.00 $3,490.30 $1,104.84 $3,594.16 $2,131.66 2026-06-12
74170 HCPCS CT Scan Of Abdomen Before And After Contrast 40 20 $2,450.70 $2,328.17 $1,117.27 $7,352.10 $2,130.88 2026-06-12
70552 HCPCS MRI Scan Of Brain With Contrast 40 20 $2,447.50 $2,325.13 $1,115.82 $7,342.50 $2,128.10 2026-06-12
6824870_1 CDM Fecal Management System Kit 20 20 $2,442.83 $2,320.69 $1,113.69 $2,393.97 $2,124.04 2026-06-12
C1731 HCPCS Catheter, Electrophysiology, Diagnostic, Other Than 3d Mapping (20 Or More Elect… 20 20 $2,442.00 $2,319.90 $1,113.31 $2,393.16 $2,123.32 2026-06-12
44202 HCPCS Partial Removal And Reconnection Of Small Bowel Using An Endoscope 20 20 $3,651.70 $3,469.12 $1,105.15 $4,975.98 $2,111.03 2026-06-12
9483034_1 CDM Ball Nose Guide Wire 2.0mm X 800mm 0103800s 20 20 $2,425.50 $2,304.23 $1,105.79 $2,376.99 $2,108.97 2026-06-12
71551 HCPCS MRI Scan Of Chest With Contrast 20 20 $2,425.30 $2,304.04 $1,105.69 $7,275.90 $2,108.80 2026-06-12
74182 HCPCS MRI Scan Of Abdomen With Contrast 20 20 $2,425.30 $2,304.04 $1,105.69 $7,275.90 $2,108.80 2026-06-12
73222 HCPCS MRI Scan Of Arm Joint With Contrast 40 20 $2,420.00 $2,299.00 $1,103.28 $7,260.00 $2,104.19 2026-06-12
70542 HCPCS MRI Scan Of Bone Of Eye Socket, Face, And/or Neck With Contrast 20 20 $2,417.90 $2,297.01 $1,102.32 $7,253.70 $2,102.37 2026-06-12
7374795_1 CDM Tfna Fen Helical Blade 95mm 20 20 $2,413.25 $2,292.59 $1,100.20 $2,364.99 $2,098.32 2026-06-12
7186006_1 CDM Tfna Helical Blade 100mm 20 20 $2,413.25 $2,292.59 $1,100.20 $2,364.99 $2,098.32 2026-06-12
6978785_1 CDM Tfna Helical Blade 95mm 20 20 $2,413.25 $2,292.59 $1,100.20 $2,364.99 $2,098.32 2026-06-12
9469745_1 CDM Velys Array Set-knee 451570011 20 20 $2,412.90 $2,292.26 $1,100.04 $2,364.64 $2,098.02 2026-06-12
6947666_1 CDM Salvation Full Rings 180mm 20 20 $2,412.00 $2,291.40 $1,099.63 $2,363.76 $2,097.23 2026-06-12
6825314_1 CDM Wright Am Surgical Blade 20 20 $2,411.50 $2,290.93 $1,099.40 $2,363.27 $2,096.80 2026-06-12
8997134_1 CDM Femoral Stem Sz3 157003090 20 20 $2,400.00 $2,280.00 $1,094.16 $2,352.00 $2,086.80 2026-06-12
8995456_1 CDM Femoral Stem Sz7 Hi 157013135 20 20 $2,400.00 $2,280.00 $1,094.16 $2,352.00 $2,086.80 2026-06-12
8860530_1 CDM Fem Stem Sz6 127mm 157013120 20 20 $2,400.00 $2,280.00 $1,094.16 $2,352.00 $2,086.80 2026-06-12
J0490 HCPCS Injection, Belimumab, 10 Mg 40 20 $2,985.33 $2,836.06 $628.19 $6,889.13 $2,080.35 2026-06-12
6908078_1 CDM Evicel 5ml 20 20 $2,388.58 $2,269.15 $1,088.95 $2,340.81 $2,076.87 2026-06-12
73719 HCPCS MRI Scan Of Leg With Contrast 40 20 $2,388.20 $2,268.79 $1,088.78 $7,164.60 $2,076.54 2026-06-12
73722 HCPCS MRI Scan Of Leg Joint With Contrast 40 20 $2,388.20 $2,268.79 $1,088.78 $7,164.60 $2,076.54 2026-06-12
73219 HCPCS MRI Scan Of Arm With Contrast 40 20 $2,388.20 $2,268.79 $1,088.78 $7,164.60 $2,076.54 2026-06-12
6903950_1 CDM Wright Staple Kit 20 20 $2,383.50 $2,264.33 $1,086.64 $2,335.83 $2,072.45 2026-06-12
6857916_1 CDM Wright Fuseforce 8x8 20 20 $2,383.50 $2,264.33 $1,086.64 $2,335.83 $2,072.45 2026-06-12
8980635_1 CDM Graft Spreader Ar19007gs 20 20 $2,362.50 $2,244.38 $1,077.06 $2,315.25 $2,054.19 2026-06-12
8560066_1 CDM Sterile Hook Blade 3055 20 20 $2,356.20 $2,238.39 $1,074.19 $2,309.08 $2,048.72 2026-06-12
44140 HCPCS Partial Removal Of Large Bowel With Connection 20 20 $3,540.40 $3,363.38 $1,072.00 $4,818.64 $2,046.36 2026-06-12
7530656_1 CDM Drill Templates - Nitinol 20 20 $2,338.88 $2,221.94 $1,066.30 $2,292.10 $2,033.65 2026-06-12
6824786_1 CDM Ligasure Impact Lf4418 20 20 $2,338.70 $2,221.77 $1,066.21 $2,291.93 $2,033.49 2026-06-12
72196 HCPCS MRI Scan Of Pelvis With Contrast 20 20 $2,320.30 $2,204.29 $1,057.82 $6,960.90 $2,017.50 2026-06-12
72131 HCPCS CT Scan Of Lower Spine Without Contrast 20 20 $2,305.50 $2,190.23 $1,051.08 $6,916.50 $2,004.63 2026-06-12
9110939_1 CDM 10.0mm Hollow Drill Bit 03019003 20 20 $2,300.45 $2,185.43 $1,048.78 $2,254.44 $2,000.25 2026-06-12
72125 HCPCS CT Scan Of Upper Spine Without Contrast 40 20 $2,289.60 $2,175.12 $1,043.83 $6,868.80 $1,990.81 2026-06-12
5770872_1 CDM CT Neck Angiography 10 10 $3,182.10 $3,023.00 $1,400.12 $3,023.00 $1,988.82 2026-06-12
7192845_1 CDM CT Neck Angiography Tc 10 10 $3,182.10 $3,023.00 $1,400.12 $3,023.00 $1,988.82 2026-06-12
7743853_1 CDM Drill Bit 4.3mm, 413mm Length 20 20 $2,271.92 $2,158.32 $1,035.77 $2,226.48 $1,975.43 2026-06-12
7394583_1 CDM 10mm Metatarsal Instrument Set 20 20 $2,268.00 $2,154.60 $1,033.98 $2,222.64 $1,972.03 2026-06-12
6890924_1 CDM Endoscopic Curved Stapler 33mm 20 20 $2,267.06 $2,153.71 $1,033.55 $2,221.72 $1,971.21 2026-06-12
6890923_1 CDM Endoscopic Curved Stapler 29mm 20 20 $2,267.06 $2,153.71 $1,033.55 $2,221.72 $1,971.21 2026-06-12
70492 HCPCS CT Scan Of Soft Tissue Of Neck Before And After Contrast 20 20 $2,251.40 $2,138.83 $1,026.41 $6,754.20 $1,957.60 2026-06-12
70491 HCPCS CT Scan Of Soft Tissue Of Neck With Contrast 20 20 $2,249.30 $2,136.84 $1,025.46 $6,747.90 $1,955.77 2026-06-12
29867 HCPCS Repair Of Knee Cartilage And Bone With Donor Cartilage Graft Using An Endoscope 20 20 $3,359.10 $3,191.15 $1,021.39 $3,286.21 $1,954.53 2026-06-12
58554 HCPCS Removal Of Uterus, Tubes, And/or Ovaries Through Vagina Using An Endoscope, More… 20 20 $3,439.70 $3,267.72 $1,014.07 $3,267.72 $1,954.10 2026-06-12
72141 HCPCS MRI Scan Of Upper Spinal Canal Without Contrast 40 20 $2,422.65 $2,301.52 $974.26 $8,124.90 $1,952.15 2026-06-12
8998936_1 CDM Implant System Ar1788pjcp 20 20 $2,242.50 $2,130.38 $1,022.36 $2,197.65 $1,949.86 2026-06-12
9019736_1 CDM Pars Implant System Ar8862ds 20 20 $2,242.50 $2,130.38 $1,022.36 $2,197.65 $1,949.86 2026-06-12
7328667_1 CDM Abstack Fixation Device 20 20 $2,224.25 $2,113.04 $1,014.04 $2,179.77 $1,933.99 2026-06-12
72128 HCPCS CT Scan Of Middle Spine Without Contrast 20 20 $2,209.00 $2,098.55 $1,007.08 $6,627.00 $1,920.73 2026-06-12
9454714_1 CDM Burr Straight 19.5mm 2.0mm Ar300b201 20 20 $2,205.00 $2,094.75 $1,005.26 $2,160.90 $1,917.25 2026-06-12
9471406_1 CDM Burr Conical 13mm 4.3mm Ar300b101 20 20 $2,205.00 $2,094.75 $1,005.26 $2,160.90 $1,917.25 2026-06-12
9519684_1 CDM Burr, Straight 12mm, Dia 2.2mm Ar300b003 20 20 $2,205.00 $2,094.75 $1,005.26 $2,160.90 $1,917.25 2026-06-12
9530136_1 CDM Burr, Shannon Rec 3.1x20.0mm Ar301b202 20 20 $2,205.00 $2,094.75 $1,005.26 $2,160.90 $1,917.25 2026-06-12
9059225_1 CDM Triple-edge Release Instrument Sn21 20 20 $2,205.00 $2,094.75 $1,005.26 $2,160.90 $1,917.25 2026-06-12
9006947_1 CDM Speedrelease Guided Instr Sn20 20 20 $2,205.00 $2,094.75 $1,005.26 $2,160.90 $1,917.25 2026-06-12
9465290_1 CDM Burr, Straight, 19.5mm Diam 2.0mm Ar300b202 20 20 $2,205.00 $2,094.75 $1,005.26 $2,160.90 $1,917.25 2026-06-12
9059226_1 CDM Hooked Bone Removal Osteotome Sn25 20 20 $2,205.00 $2,094.75 $1,005.26 $2,160.90 $1,917.25 2026-06-12
7575879_1 CDM Altis Sling System 519650 20 20 $2,200.50 $2,090.48 $1,003.21 $2,156.49 $1,913.34 2026-06-12
47610 HCPCS Removal Of Gallbladder With Exploration Of Common Bile Duct 20 20 $3,312.50 $3,146.88 $1,002.43 $4,504.16 $1,911.95 2026-06-12
9040265_1 CDM Allomatrix Injectable Putty 10cc 86001000 20 20 $2,197.50 $2,087.63 $1,001.84 $2,153.55 $1,910.72 2026-06-12
44160 HCPCS Partial Removal Of Small And Large Bowel With Attachment Of Small And Large Bowe… 20 20 $3,279.60 $3,115.62 $993.73 $4,461.29 $1,895.12 2026-06-12
7380601_1 CDM Aquamantys 6.0 Bipolar Sealer 20 20 $2,173.50 $2,064.83 $990.90 $2,130.03 $1,889.86 2026-06-12
73701 HCPCS CT Scan Of Leg With Contrast Material 40 20 $2,164.50 $2,056.28 $986.80 $6,493.50 $1,882.03 2026-06-12
29889 HCPCS Repair Of Posterior Cruciate Ligament Of Knee Using An Endoscope 20 20 $3,206.50 $3,046.18 $981.49 $3,150.38 $1,874.31 2026-06-12
27244 HCPCS Treatment Of Broken Neck Of Thigh Bone With Plate/screw Implant 20 20 $3,231.90 $3,070.31 $971.80 $3,147.00 $1,869.38 2026-06-12
27245 HCPCS Treatment Of Broken Neck Of Thigh Bone With Bone Implant 20 20 $3,230.90 $3,069.36 $969.75 $3,142.78 $1,866.70 2026-06-12
44120 HCPCS Partial Removal Of Small Bowel With Reconnection 20 20 $3,238.30 $3,076.39 $972.32 $4,383.09 $1,859.07 2026-06-12
7600990_1 CDM Staple Refill, 60mm Egia60avm 20 20 $2,135.88 $2,029.09 $973.75 $2,093.16 $1,857.15 2026-06-12
6824987_1 CDM Vapr Hook Electrode With Int Hp 20 20 $2,135.70 $2,028.92 $973.67 $2,092.99 $1,856.99 2026-06-12
58291 HCPCS Removal Of Uterus, Tubes, And/or Ovaries Through Vagina, More Than 250.0 G 20 20 $3,199.10 $3,039.15 $956.01 $3,039.15 $1,852.39 2026-06-12
7407954_1 CDM Drill Kit Speed Arc 2.0mm Bit 20 20 $2,126.25 $2,019.94 $969.36 $2,083.73 $1,848.78 2026-06-12
72146 HCPCS MRI Scan Of Middle Spinal Canal Without Contrast 40 20 $2,269.45 $2,155.98 $919.64 $7,565.10 $1,842.72 2026-06-12
58573 HCPCS Removal Of Uterus, Tubes, And/or Ovaries Through Abdomen Using An Endoscope, Mor… 20 20 $3,014.60 $2,863.87 $959.71 $2,863.87 $1,838.21 2026-06-12
7714339_1 CDM Myosure Fluent Disposable Set 20 20 $2,112.71 $2,007.07 $963.18 $2,070.46 $1,837.00 2026-06-12
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